Panic Attacks: Symptoms, Causes, and Treatment Options

A panic attack is a sudden episode of intense fear, accompanied by strong physical symptoms. The attack usually reaches its peak within 10–20 minutes and subsides within half an hour, but during this time a person may be convinced that their heart is failing or that they are about to die.

Panic attacks are relatively common — around 11% of the population experience at least one panic attack at some point in their lives. When the attacks recur and a person is constantly worried about having another one, this is referred to as panic disorder.

Symptoms of a panic attack

A panic attack presents as a combination of symptoms that begin suddenly:

Physical symptoms

Sudden rapid heartbeat or a sensation that the heart is stopping

Sweating, tremor, shaking

Shortness of breath, a feeling of “air hunger”

Chest pain or discomfort

Nausea, abdominal pain

Dizziness, weakness

Numbness or tingling in the body (paresthesia)

Hot or cold flashes

Psychological symptoms

Fear of dying or “going crazy”

Feeling detached from reality (derealization)

Fear of losing control

Persistent anxiety about the possibility of another attack

Panic attack or heart attack?

The symptoms of a panic attack often resemble cardiological problems, which frequently leads patients to the emergency department. Key differences include:

Panic attack: begins abruptly and resolves within 20–30 minutes; chest pain is usually sharp or stabbing; symptoms are associated with emotional stress.

Cardiac problem: the pain may radiate to the left arm; it does not go away within 30 minutes; it is associated with physical exertion.

Important: If you are experiencing these symptoms for the first time, you should urgently consult a doctor to rule out a cardiological condition.

Causes of Panic Disorder

Several factors contribute to the development of panic disorder:

Neurobiological factors: hyperactivity of the brain’s “fear center” (the amygdala), imbalance of neurotransmitters, and dysregulation of the autonomic nervous system.

Genetics: A family history of panic disorder increases the risk by 4–8 times.

Stress: major life changes, loss, traumatic experiences.

Behavioral factors: excessive caffeine consumption, sleep deprivation, lack of physical activity.

Treatment of panic attacks

Panic disorder responds well to treatment. At GSMRC, we use a combined treatment approach:

Cognitive-behavioral therapy (CBT)

CBT is the gold standard for treating panic disorder. Psychotherapists at GSMRC will use:

Cognitive restructuring — changing catastrophic thinking patterns

Interoceptive exposure — simulating the physical symptoms of an attack in a safe environment

Breathing retraining to prevent hyperventilation

Medication treatment

If needed, the psychiatrist may prescribe:

SSRI antidepressants—paroxetine, sertraline—for the long-term prevention of panic attacks

Benzodiazepines — only in acute cases, for short-term use under a doctor’s supervision

SNRI — venlafaxine, if an SSRI is insufficiently effective

What should we do during a panic attack?

If you are having a panic attack:

Pause and breathe — slowly and deeply: inhale for 4 seconds, hold for 4 seconds, exhale for 6 seconds

Remind yourself: “This is a panic attack. It is not dangerous. It will pass.”

5-4-3-2-1 technique: name 5 things you can see, 4 things you can hear, 3 things you can touch, 2 things you can smell, and 1 thing you can taste

Do not run away from the situation — escaping only strengthens anxiety in the future.

Panic disorder and co-occurring conditions

Panic disorder often co-occurs with other mental health conditions:

Depression — in 50–65% of patients

Generalized Anxiety Disorder

Agoraphobia — avoiding certain places or situations

Substance dependence

This is why a multidisciplinary approach is used at GSMRC — a psychiatrist and a psychotherapist work together to support the patient’s overall well-being.

Book a consultation

For the diagnosis and treatment of panic attacks:

Phone: +995 32 2 440 550

Address: Togo Gudava Street, Tbilisi

Center: GSMRC — Guga Sikharulidze Mental Health Research Center